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Individual

SANDY JULISSA LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-0288
Mailing address
18 SAXONY RD, FRAMINGHAM, MA 01701-7762
(508) 333-3483

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2302851
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2302851
MA

Other

Enumeration date
05/01/2023
Last updated
08/07/2024
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